Individual ProviderKavyashri Kodlipet JagadeeshInternal MedicineAllopathic & Osteopathic PhysiciansPractice Address1330 Rockefeller Ave Ste 210, Everett, WA 98201-1676(425) 261-4940(866) 366-2983PECOS EnrollmentBased on the most recent information from CMS, provider Kavyashri Kodlipet Jagadeesh is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1013296771Provider TypeIndividualFull NameKodlipet Jagadeesh, KavyashriTitleDr.CredentialMDGenderFemaleSole ProprietorNoEnumeration Date8/12/2011Last Updated2/4/2022Contact InformationPractice LocationPractice Address1330 Rockefeller Ave Ste 210, Everett, WA 98201-1676Phone(425) 261-4940Fax(425) 261-4932Mailing LocationMailing AddressPO Box 3360, Portland, OR 97208-3360Phone(866) 366-2983FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode207R00000XPrimaryDescriptionInternal MedicineAllopathic & Osteopathic PhysiciansLicenseMD61170649Washington